Suturing apparatus and method

ABSTRACT

Disclosed embodiments include apparatuses, systems, and methods for driving a needle to facilitate suturing, such as may be performed in a surgical anastomosis procedure. In an illustrative embodiment, an apparatus includes a frame. First and second rollers are rotatably mounted parallel with each other in the frame and are configured to engage therebetween a shaft of a needle formed in a helical shape. The first and second rollers are configured to counter-rotate. The needle is revolvable eccentrically around the first roller responsive to counter-rotation of the first and second rollers. A drive mechanism is secured to the frame and is configured to move the frame.

FIELD

The present disclosure relates to apparatuses, systems, and methods forsuturing an object such as a juncture of two passages.

BACKGROUND

The statements in this section merely provide background informationrelated to the present disclosure and may not constitute prior art.

Surgical anastomosis enables segments of one or more arteries, bloodvessels, intestines, or any other passages to be connected orreconnected, such as in coronary artery bypass graft (CABG) procedures.In a CABG procedure, for example, a saphenous vein may be harvested froma patient's leg and grafted to circumvent a coronary arterial blockage.Such procedures are tremendously useful and may regularly save andextend lives.

However, CABG procedures and similar procedures involve highly invasivesurgery. For example, a typical CABG procedure involves performing amedian sternotomy in which a vertical incision is made along thepatient's sternum, after which the sternum itself is actually brokenopen to provide access to the heart and surrounding arteries. The mediansternotomy provides a surgeon with space to insert a graft and suturethe graft to a coronary artery to complete the process. However, thesizable incision and the breaking of the sternum may involve significantscarring, discomfort, and risk of infection, and may require significantrecovery time for the healing of the affected structures.

SUMMARY

Disclosed embodiments include apparatuses, systems, and methods fordriving a needle to facilitate suturing, such as may be performed in asurgical anastomosis procedure involving veins, arteries, or otherpassages.

In an illustrative embodiment, an apparatus includes a frame. First andsecond rollers are rotatably mounted parallel with each other in theframe and are configured to engage therebetween a shaft of a needleformed in a helical shape. The first and second rollers are configuredto counter-rotate. The needle is revolvable eccentrically around thefirst roller responsive to counter-rotation of the first and secondrollers. A drive mechanism is secured to the frame and is configured tomove the frame.

In another embodiment, a system includes a needle formed in a helicalshape, where the needle includes a shaft having a trailing endconfigured to draw a filament and a leading end shaped to pierce anobject. A drive track is positionable to guide a path of the needle. Aneedle drive mechanism includes a frame. First and second rollers arerotatably mounted parallel with each other in the frame and areconfigured to engage therebetween a shaft of a needle formed in ahelical shape. The first and second rollers are configured tocounter-rotate. The needle is revolvable eccentrically around the firstroller responsive to counter-rotation of the first and second rollers. Adrive mechanism is secured to the frame and is configured to move theframe along the drive track.

In a further illustrative embodiment, in an illustrative method opposingsides of a shaft of a needle are engaged between parallel faces of firstand second rollers, where the needle is formed in a helical shape andconfigured to draw a filament from its trailing end. The first andsecond rollers are counter-rotated to cause the helically-shaped needleto revolve eccentrically around the first roller positioned adjacent toan object to cause a leading end of the needle to pierce the objectadjacent to an outer face of the first roller. The first and secondrollers are translated along an edge of the object. Counter-rotating thefirst and second rollers and translating the first and second rollerscauses the needle to draw the filament to suture the edge of the objectadjacent the outer face of the first roller.

Further features, advantages, and areas of applicability will becomeapparent from the description provided herein. It will be appreciatedthat the description and specific examples are intended for purposes ofillustration only and are not intended to limit the scope of the presentdisclosure.

DRAWINGS

The drawings described herein are for illustration purposes only and arenot intended to limit the scope of the present disclosure in any way.The components in the figures are not necessarily to scale, withemphasis instead being placed upon illustrating the principles of thedisclosed embodiments. In the drawings:

FIG. 1 is a perspective view of an embodiment of an apparatus forsuturing an object with a helically-shaped needle;

FIG. 2 is a perspective view in partial cutaway form of the apparatus ofFIG. 1;

FIGS. 3 and 4 are top and bottom perspective views, respectively, of theapparatus of FIG. 1 positioned on a drive track for guiding theapparatus of FIG. 1;

FIGS. 5 and 6 are views of the apparatus of FIG. 1 at differentlocations along the guide track of FIGS. 3 and 4 to illustrate a processof suturing using the apparatus of FIG. 1;

FIG. 7 is a perspective view of a system having a motor to impartrotational force to the apparatus of FIG. 1; and

FIG. 8 is a flow diagram of an illustrative method of suturing anobject.

DETAILED DESCRIPTION

It will be noted that the first digit of three-digit reference numberscorresponds to the figure number in which the element first appears.

The following description explains, by way of illustration only and notof limitation, various embodiments of noninvasive apparatuses, systems,and methods for suturing an object, such as a juncture of passages beingjoined together in a surgical anastomosis procedure.

Given by way of non-limiting overview and referring to FIG. 1, invarious embodiments an apparatus 100 includes a frame 110. Rollers 120and 121 are rotatably mounted parallel with each other in the frame 110and are configured to engage therebetween a shaft 191 of a needle 190formed in a helical shape. The rollers 120 and 121 are configured tocounter-rotate. The needle 190 is revolvable eccentrically around theroller 120 responsive to counter-rotation of the rollers 120 and 121. Adrive mechanism 150 is secured to the frame 110 and is configured tomove the frame 110.

Now that an overview has been given, details of various embodiments willbe explained by way of non-limiting examples given by way ofillustration only and not of limitation.

Still referring to FIG. 1, in various embodiments the apparatus 100 maybe well suited for suturing together passages or other objects. In suchembodiments the frame 110 is adapted for supporting the rollers 120 and121. The rollers 120 and 121 are configured to drive the needle 190 todraw a filament to suture one or more objects (not shown in FIG. 1). Inthe example of a CABG procedure, the objects may include an end of adonor passage and an opening in a receiving passage that may be joinedtogether with sutures to complete an anastomosis procedure. In variousembodiments the apparatus 100 is adapted to be compact for insertioninto a bodily cavity, for example, by insertion into a patient's chestcavity via a subxiphoid incision made below a sternum of the patient(not shown). It will be appreciated that insertion of the apparatus 100inserted through a relatively minor incision for use in suturing mayhelp contribute to reducing potential trauma, risk, and protractedhealing process that may result from performance of a median sternotomy,as commonly may be used to perform the implantation and suturing of adonor vein in a conventional CABG procedure.

However, it will be appreciated that use of the apparatus 100 is notlimited to CABG procedures. Given by way of non-limiting examples, theapparatus 100 may be used for suturing in other procedures, such aswithout limitation, forming suturing an arteriovenous fistula between anartery and a vein for dialysis, suturing a colostomy formed between thebowel and the skin of the abdominal wall, or in coupling ends ofintestinal sections when a formerly intervening portion has beenremoved. As such, it will be appreciated that no such limitations areintended and are not to be inferred.

In various embodiments, recesses in the frame 110 receive the rollers120 and 121, as further described below with reference to FIG. 2. Therecesses in the frame enable the rollers 120 and 121 to rotate and to bedriven by an external source of rotational force. Although only theroller 120 is exposed in FIG. 1, the roller 121 may have a structuresimilar to that of the roller 120, as described below with reference toFIG. 2. The roller 120 includes a cylinder 122 which defines a number ofgrooves 124 that are sized and shaped to engage the shaft 191 of theneedle 190. Specifically, the grooves 124 are shaped to have a width andcross-sectional shape to at least partially receive the shaft 191 of theneedle 190. The grooves 124 also are angled to accommodate a pitch ofthe needle 190. The width and pitch of the grooves 124 are furtherdescribed below with reference to FIG. 2. In various embodiments, thecylinder 122 of the roller 120 may also define feature the grooves 124,while the roller 121 may have a generally flat surface or flat andtextured surface configured to press the needle 190 into the grooves 124of the roller 120.

In various embodiments, drive gears 126 and 127 are configured to engagethe rollers 120 and 121, respectively. In some embodiments, the drivegears 126 and 127 may be coupled with the rollers 120 and 121,respectively. In some other embodiments, the drive gears 126 and 127 maybe integrally formed as part of the rollers 120 and 121, respectively.The drive gears 126 and 127 are interleaved so that rotation of theroller 120 in a first direction causes the roller 121 to counter-rotatein a second, opposite direction. As a result, imparting a rotationalforce to the roller 121, for example, causes the roller 121 to rotate ina first rotational direction (as indicated by an arrow 128) and causethe roller 120 to counter-rotate in a second rotational direction (asindicated by an arrow 129 that is opposite the first rotationaldirection). A rotatable member 130, such as a drive shaft or a drivecable, may be directly mechanically coupled to the roller 120 or theroller 121 to provide rotational force to one of the rollers 120 and 121to cause the rollers 120 and 121 to counter-rotate.

In various embodiments, the needle 190 has a radius larger than that ofthe roller 120 around which the needle 190 rotates. Thus, when the shaft191 of the needle 190 is engaged between the rollers 120 and 121, anaxis of the needle 190 and an axis of the roller 120 are not colinear.As a result, rotation of the needle 190 (caused by the counter-rotationof the rollers 120 and 121) causes the needle 190 to rotateeccentrically around the roller 120. The eccentric rotation of theneedle 190 enables the rollers 120 and 121 to drive the needle 190,thereby causing the needle 190 to repeatedly pierce an object (not shownin FIG. 1) that is adjacent to the roller 120.

In various embodiments, the apparatus 100 may be adapted to follow adrive track (not shown in FIG. 1) that guides the apparatus 100 tooperate along a particular course around an object to be sutured (notshown in FIG. 1). In such embodiments, a guide bracket 140 may bedisposed on the frame 110. The guide bracket 140 defines an internalguide 142 that is shaped to receive an edge of the drive track so as tohold the frame 110 onto the drive track. The guide bracket 140 also maybe configured to receive a drive mechanism 150 and to hold the drivemechanism 150 against the drive track to enable the drive mechanism 150to motivate the apparatus 100 along the drive track. The frame 110 mayinclude one or more transverse rollers 146 that are configured torollably engage the drive track to hold the frame 110 to the drivetrack. The transverse rollers 146 may be mounted on the frame 110 on oradjacent to the guide bracket 140 as shown in FIG. 1.

In various embodiments, the drive mechanism 150 includes a worm gear 152that is pitched so that rotation of the worm gear 152 moves theapparatus 100 along the drive track. In some embodiments, the worm gear152 is configured to engage a rotatable drive member 154 that providesrotational force to the worm gear 152. In some other embodiments, theworm gear 152 may be engaged through one or more gears (not shown inFIG. 1) with the rotatable member 130 or one or more of the rollers 120and 121 to provide rotational force to the worm gear 152.

Referring additionally to FIG. 2, in various embodiments both therollers 120 and 121 include grooves 124 and 225, respectively, to engagethe shaft 191 of the needle 190. As shown in FIG. 2, the grooves 124 and225 are pitched in opposite directions to pinchably and rollably engagethe shaft 191 of the needle 190. A width 247 of the grooves 124 and 225is sized to releasably engage a width 290 of the shaft 191 of the needle190. A pitch φ of the grooves 124 and 225 match a pitch θ of the needle190. The corresponding widths 247 and 290 and corresponding pitches φand θ enable the rollers 120 and 121 to drive eccentric rotation of theneedle 190 around the roller 120 as the rollers 120 and 121counter-rotate. The needle 190 itself includes a leading end 292 that isshaped to pierce an object or objects, such as without limitationtissues that may include edges of donor and receiving passages to besutured together by the apparatus 100 (FIG. 1). The needle 190 also mayinclude a trailing end 294 configured to receive or to be attached to afilament 299 that is used to suture together the object.

Still referring to FIG. 2, the rollers 120 and 121 include cylinders 122and 223, respectively, that are rotatably received in the frame 110. Atone end, the cylinders 122 and 223 may be rotatably received incylindrical openings 214 that extend through the frame 110. At anopposing end, each of the cylinders 122 and 223 may be received in arounded recess 212 or in a cylindrical opening 214. In some embodimentsthe cylindrical opening 214 may enable a drive shaft 229, that isfixably coupled with the roller 121, to extend through the frame 110. Insuch embodiments, the drive shaft 229 may thus engage the rotatablemember 130, thereby providing rotational force to the roller 121. Therotational force is also provided to the roller 120 via the interleaveddrive gears 126 and 127, thereby causing the roller 120 and the roller121 to counter-rotate. It will be appreciated that, in some otherembodiments, the drive shaft 229 may be fixably coupled with the roller120 such that the interleaved drive gears 126 and 127 impart rotationalforce to the roller 121, thereby causing the roller 120 and the roller121 to counter-rotate.

In various embodiments, the rotatable member 130 may be mechanicallyjoined to the drive shaft 229 by a coupling 232 which may be securableand removable by an attachment device 234, such as without limitation aninset screw. The rotatable member 130 may be driven by a motor (notshown in FIG. 2) that is disposed external to the apparatus 100. Thecylindrical openings 214 and/or the rounded recess 212 may includebushings (not shown in FIG. 2) formed of nylon or other materials toreduce friction and/or vibration between the rollers 120 and 121 and theframe 110 and/or between the drive shaft 229 and the frame 110.

Referring additionally to FIG. 3, in various embodiments a drive track300 is used to guide the apparatus (not shown in FIG. 3) around anobject to be sutured. FIG. 3 shows a donor passage 360 having a distaledge 361 to be joined to a receiving passage (not shown in FIG. 3) as inan anastomosis procedure. The drive track 300 may include separatesections 302 and 303 that may be positioned around an object, such asthe donor passage 360, and then mechanically coupled at a junction 304.The drive track 300 supports teeth 306 that are shaped and sized to beengaged by the worm gear 152. In various embodiments, rotational forceimparted by the rotational drive member 154 drives the worm gear 152and, thus, causes the worm gear 152 to translate the apparatus 100 alongthe guide track 300. The interaction of the worm gear 152 and the drivetrack 300 thus causes the apparatus 100 to translate along an edge ofthe object, such as the distal end 361 of the donor passage 360. Invarious embodiments the drive track 300 includes inner channels 308defined along the object that enable the needle (not shown in FIG. 3) toextend from the apparatus 100 to and through the object.

Referring additionally to FIG. 4, the guide bracket 140 of the frame 110guides the apparatus 100 along the drive track 300. The receivingpassage 362 defines an opening 363 beneath the drive track 300. Theguide bracket 140 engages the drive track 300, and the drive track 300is received in the internal guide 142 defined by the guide bracket 140.As previously described, the guide bracket 140 holds the worm gear 152against the teeth 306 of the drive track 300. As a result, rotationalforce imparted to the worm gear 152 by the rotational drive member 154causes the worm gear 152 to move the apparatus 100 around the drivetrack as the needle 190 passes through the channels 308 in the drivetrack 300 to suture the object.

Referring additionally to FIGS. 5 and 6, the apparatus 100 moves aroundthe drive track 300 as the needle 190 is rotated to suture the object.As shown in FIG. 5, the apparatus 100 is situated at a first point 500along the drive track 300, and the needle 190 extends through a firstchannel 501 in the drive track 300. As shown in FIG. 6, rotation of theworm gear 152 has moved the apparatus 100 along the guide track 300 to asecond point 600 while the needle 190 has been rotated. As a result, theneedle 190 now extends through a second channel 603 in the drive track300. The motion of the apparatus 100 around the guide track 300 as theneedle 190 is rotated through an object thus sutures the object (whichin this non-limiting example is a juncture of the donor passage 360 andthe receiving passage 362).

It will be appreciated that, as shown in FIGS. 3-6, the drive track 300suitably is a rounded track configured to lead the apparatus 100 aroundan object to suture the object, for example, to join passages together.However, it will be appreciated that a linear drive track may be used toform a linear suture, for example, to close a wound or incision. Thus,it will be appreciated that disclosed embodiments are not intended to belimited to a drive track 300 of any particular shape or size and no suchlimitation is to be inferred.

Referring additionally to FIG. 7 and in various embodiments, in anillustrative system 700 the drive track 300 is positioned around theobject or objects to be sutured. A motor 780 provides rotational forceto rotate the rollers 120 and 121 (not shown in FIG. 7) and to drive theworm gear 152. In various embodiments, a single motor 780 or multiplemotors (not shown) may be used to provide rotational force to therollers 120 and 121 and the worm gear 152 of the drive mechanism 150.The motor 780 may include a gear box 782 so that, as desired, the singlemotor 780 may provide rotational force at different speeds to therotational member 130 that is coupled with the rollers 120 and 121 andthe rotational drive member 154 that is coupled to the worm gear 152 ofthe drive mechanism 150. The system 700 may include drive linkages 784and 786 to connect with the rotational member 130 and the rotationaldrive member 154. The drive linkages 784 and 786 may include flexibledrive cables to provide rotational force while accommodating motion andpositioning of the apparatus 100.

In various embodiments and as shown in FIG. 7, the gear box 782 may bepositioned at or adjacent to the motor 780 with multiple drive linkages784 and 786 extending to the rollers 120 and 121 and to the drivemechanism 150. In some other embodiments, the gear box 782 may bepositioned at the apparatus 100 so that rotational force imparted to oneof the rollers 120 and 121 may be mechanically conveyed to the drivemechanism 150 or vice versa. As a result, with only a single linkageextending from the motor 780 to the apparatus, in such embodimentsrotational force may be provided to both the rollers 120 and 121 and tothe drive mechanism 150.

Referring additionally to FIG. 8, in various embodiments an illustrativemethod 800 of suturing an object, such as in an anastomosis, isprovided. The method 800 starts at a block 805. At a block 810, opposingsides of a shaft of a needle are engaged between parallel faces of firstand second rollers, where the needle is formed in a helical shape and isconfigured to draw a filament from its trailing end. At a block 820, thefirst and second rollers are counter-rotated to cause thehelically-shaped needle to revolve eccentrically around the first rollerthat is positioned adjacent to an object. Counter-rotation of the firstand second rollers causes a leading end of the needle to pierce theobject adjacent to an outer face of the first roller. At a block 830,the first and second rollers are translated along an edge of the object.Counter-rotating the first and second rollers and translating the firstand second rollers causes the needle to draw the filament to suture theedge of the object adjacent the outer face of the first roller. With theobject sutured, the method 800 ends at a block 835.

It will be appreciated that the detailed description set forth above ismerely illustrative in nature and variations that do not depart from thegist and/or spirit of the claimed subject matter are intended to bewithin the scope of the claims. Such variations are not to be regardedas a departure from the spirit and scope of the claimed subject matter.

What is claimed is:
 1. An apparatus comprising: a frame; first andsecond rollers rotatably mounted parallel with each other in the frameand configured to engage therebetween a shaft of a needle formed in ahelical shape, the first and second rollers being configured tocounter-rotate, the needle being revolvable eccentrically around thefirst roller responsive to counter-rotation of the first and secondrollers; and a drive mechanism secured to the frame and configured tomove the frame.
 2. The apparatus of claim 1, wherein faces of at leastone of the first roller and the second rollers defines angled groovesthat are sized to at least partially receive the shaft of the needle andthat are angled to align with a pitch of the helical shape of theneedle.
 3. The apparatus of claim 1, further comprising: a first drivegear configured to engage the first roller; and a second drive gearconfigured to engage the second roller, the first drive gear and thesecond drive gear being further configured to cooperate with each othersuch that the first roller is rotatable in a first rotational directionand the second roller is counter-rotatable in a second rotationaldirection that is opposite the first rotational direction.
 4. Theapparatus of claim 3, further comprising a roller drive shaft configuredto receive a rotatable member that is configured to provide rotationalforce to cause the first and second rollers to counter-rotate.
 5. Theapparatus of claim 1, wherein the drive mechanism includes: a worm gearrotatably received in the frame and configured to engage a drive track;and a guide bracket disposed on the frame and configured to support theworm gear in engagement with the drive track, the frame beingmotivatable along the drive track responsive to rotation of the wormgear.
 6. The apparatus of claim 5, further comprising at least onetransverse roller mounted on the frame and configured to rollinglyengage the drive track to maintain the guide bracket in position to holdthe worm gear against the drive track.
 7. The apparatus of claim 5,wherein the drive mechanism is further configured to cause the worm gearto rotate by a causality chosen from: mechanically engaging at least oneof the first and second rollers so that rotation of the at least one ofthe first and second rollers causes the worm gear to rotate andreceiving a rotatable drive member configured to provide rotationalforce to cause the worm gear to rotate.
 8. A system comprising: a needleformed in a helical shape, wherein the needle includes a shaft having atrailing end configured to draw a filament and a leading end shaped topierce an object; a drive track is positionable to guide a path of theneedle; and a needle drive mechanism including: a frame; first andsecond rollers rotatably mounted parallel with each other in the frameand configured to engage therebetween a shaft of a needle formed in ahelical shape, the first and second rollers being configured tocounter-rotate, the needle being revolvable eccentrically around thefirst roller responsive to counter-rotation of the first and secondrollers; and a drive mechanism secured to the frame and configured tomove the frame along the drive track.
 9. The system of claim 8, whereinfaces of at least one of the first roller and the second rollers definesangled grooves that are sized to at least partially receive the shaft ofthe needle and that are angled to align with a pitch of the helicalshape of the needle.
 10. The system of claim 8, further comprising: afirst drive gear configured to engage the first roller; and a seconddrive gear configured to engage the second roller, the first drive gearand the second drive gear being further configured to cooperate witheach other such that the first roller is rotatable in a first rotationaldirection and the second roller is counter-rotatable in a secondrotational direction that is opposite the first rotational direction.11. The system of claim 10, further comprising a roller drive shaftconfigured to receive a rotatable member that is configured to providerotational force to cause the first and second rollers tocounter-rotate.
 12. The system of claim 8, wherein the drive mechanismincludes: a worm gear rotatably received in the frame and configured toengage a drive track; and a guide bracket disposed on the frame andconfigured to support the worm gear in engagement with the drive track,the frame being motivatable along the drive track responsive to rotationof the worm gear.
 13. The system of claim 12, further comprising atleast one transverse roller mounted on the frame and configured torollingly engage the drive track to maintain the guide bracket inposition to hold the worm gear against the drive track.
 14. The systemof claim 12, wherein the drive mechanism is further configured to causethe worm gear to rotate by a causality chosen from: mechanicallyengaging at least one of the first and second rollers so that rotationof the at least one of the first and second rollers causes the worm gearto rotate and receiving a rotatable drive member configured to providerotational force to cause the worm gear to rotate.
 15. A methodcomprising: engaging opposing sides of a shaft of a needle betweenparallel faces of first and second rollers, wherein the needle is formedin a helical shape and configured to draw a filament from its trailingend; counter-rotating the first and second rollers to cause thehelically-shaped needle to revolve eccentrically around the first rollerpositioned adjacent to an object to cause a leading end of the needle topierce the object adjacent to an outer face of the first roller; andtranslating the rollers along an edge of the object, whereincounter-rotating the first and second rollers and translating the firstand second rollers causes the needle to draw the filament to suture theedge of the object adjacent the outer face of the first roller.
 16. Themethod of claim 15, wherein the first and second rollers are inverselyrotationally coupled so that rotation of the first roller causes thesecond roller to rotate in an opposite direction.
 17. The method ofclaim 16, further comprising applying an external source of rotationalforce to one of the first roller and the second roller to cause thefirst and second rollers to counter-rotate.
 18. The method of claim 17,wherein counter-rotating the first and second rollers causes the firstand second rollers to translate along the edge of the object by aprocess chosen from mechanically coupling the drive mechanism to thefirst and second rollers so that rotating the first and second rollerscauses the drive mechanism to translate the first and second rollersalong the edge of the object and applying an additional source ofrotational force to the drive mechanism to translate the first andsecond rollers along the edge of the object.
 19. The method of claim 18,further comprising positioning a drive track engageable by the drivemechanism along the edge of the object to guide the translation of thefirst and second rollers along the edge of the object.
 20. The method ofclaim 19, further comprising coupling together sections of the drivetrack around the object and joining together the sections of the drivetrack around the object.